Hyun Woo Lee

Detection and characterization of extracellular phospholipase A2 in pleural effusion of patients with tuberculosis

Extracellular phospholipase A2 activity has been identified in pleural fluid of patients with tuberculosis. This enzyme is a calcium requiring protein and has a pH optimum of 10.0. The enzyme was inhibited by the active site-directed histidine reagent, rho-bromophenacyl bromide. Ionic and non-ionic detergents, or the sulfhydryl reagent dithiothreitol, caused loss of enzyme activity. When substrate specificity was tested using 2-[1-14C]linoleoyl phospholipids as substrates, phosphatidyl-ethanolamine was the best substrate, followed by phosphatidylserine and phosphatidylcholine. This phospholipase A2 showed high affinity for heparin, and was recognized by a monoclonal antibody raised against phospholipase A2 from human synovial fluid. These findings suggest that an extracellular phospholipase A2, which may belong to the 14K group II phospholipase A2 family, exists in the pleural fluid of patients with tuberculosis.

Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea.

Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usually arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential for extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolonged course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She has been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed as bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenoid cystic carcinoma by bronchoscopic biopsy. The patient underwent radiation to relieve a bronchial stenosis caused by her tumor. The patient has remained well and is asymptomatic without evidence of clinical recurrence. The other case was 25 year old female. She complained shortness of breath and inspiratory difficulty during sleep. The tumor was located in upper trachea, which protruded from the posterior wall of the trachea and obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenocystic carcinoma by rigid bronchoscopic biopsy. The patient was underwent operation for removal of the mass and received radiotherapy. The patient has remained well are following up now.

Hyperinfection of strongyloides stercoralis

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders, characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold: correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been used corticosteroid for persisting polyarthritis.

Factors influencing arterial CO2 tension in cats during high frequency oscillation ventilation

High frequency ventilation (HFV) is a new ventilatory technique that uses very small tidal volume(less than the anatomic dead space) and high frequency, and classified 4 distinct types according to frequency and mode of gas delivery. The mechanism of gas transport of high frequency oscillation ventilation(HFOV) is somewhat different to other types of HFV. To evaluate the determinants of in HFOV, a study was done with a HFOV on 9 cats, and the results are : 1) was not correlated with frequency at the constant stroke volume(6 voltage) and bias flow (6L/minutes). 2) was correlated with stroke volume but not with bias flow under the constant frequency(15Hz/min) and bias flow(3 to 6L/min). From above results, the main determinant of on artificial ventilation with HFOV was stroke volume, but further study between flow, the site of delivery to the airway and humidification of bias flow and elimination is required in future research.

Chronic Dissecting Aortic Aneurysm with Right Coronary Artery Perfused Solely by False Lumen of Asceading Aorta

Dissecting aortic aneurysm is relatively rare in those under 40 years of age without high risk factors. After dessecting aortic aneurysm is occured, the coronary artery is rarely perfused by false lumen. We present a thirty two-year-old man who showed Debakey type 1 dissecting aortic aneurysm with right coronary artery perfused by false lumen of ascending aorta and with congestive heart failure due to aortic insufficiency without discernible risk factor. Medical and surgical treament(Modified Bentalls operation) were successfully performed. The pathologic report showed combined cystic medial necrosis. Now he is well tolerated and stable only with anticoagulation during follow up 18 months.